J Orthop. 2021 May-Jun; 25: 199–206.

Total knee arthroplasty in dialysis patients: Is it safe? A systematic review of the literature

Ioannis Gkiatas,a William Xiang,a,∗ Theofilos Karasavvidis,b Eric N. Windsor,c Abhinav K. Sharma,c and Peter K. Sculcoa

Knee

Purpose

This systematic review characterizes the safety and efficacy of total knee arthroplasty (TKA) in end stage renal disease (ESRD) patients due to the unique challenges they face.

Results

The cumulative complication rate for 3684 patients on dialysis for ESRD after primary TKA was 25%(N = 925/3702), with incidence rates of 2.5%(N = 92/3702) for periprosthetic joint infection, 3.7%(N = 71/1895) for reoperations, and 2.5%(N = 90/3578) for mortality.

Conclusion

Patients on dialysis for ESRD face significant mortality rates after primary TKA, in addition to other major complications. Careful counseling regarding risks and benefits should be provided prior to TKA in this population.

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